Key take away for patients:
This paper was a survey of over 300 hospitals that take care of the sickest type of heart attack called the STEMI. Best practices to improve care by reducing the time to open up the artery (called door to balloon time (D2B)) were identified.
These practices are:
1. accepting patients at a PCI hospital regardless of bed availability
2. single phone call activation of cath lab
3. emergency department physician activation
of lab without cardiology consultation
4. national data registry participation
5. Prehospital activation of the catheterization laboratory by paramedics & transferring physicians.
The most commonly reported barriers to system
implementation were hospital and cardiology group
competition and EMS transport and finances.



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